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71.
72.
Cristine S. Velazco Brenna S. Fullerton Charles R. Hong Kate A. Morrow Erika M. Edwards Roger F. Soll Tom Jaksic Jeffrey D. Horbar Biren P. Modi 《Journal of pediatric surgery》2018,53(1):108-112
Background
Necrotizing enterocolitis (NEC) is classically a disease of prematurity, with less reported regarding morbidity and mortality of this disease among other infants.Methods
Data were prospectively collected from 2009 to 2015 at 252 Vermont Oxford Network member centers on neonates with birth weight > 2500 g admitted to a participating NICU within 28 days of birth.Results
Of 1629 neonates with NEC, gestational age was 37 (36, 39) weeks, and 45% had major congenital anomalies, most commonly gastrointestinal defects (20%), congenital heart defects (18%), and chromosomal anomalies (7%). For the 23% of infants who had surgery for NEC, mortality and length of stay were 23% and 63 (36, 94) days versus 8% and 34 (22, 61) days in medical NEC. Independent predictors of mortality were congenital heart defects (p < 0.0001), chromosomal abnormalities (p < 0.05), other congenital malformations (p < 0.001), surgical NEC (p < 0.0001), and sepsis (p < 0.05). All of these in addition to gastrointestinal defects were independent predictors of increased length of stay. Nutritional morbidity at discharge included 6% receiving no enteral feeds and 27% who were < 10th percentile weight-for-age.Conclusions
Major congenital anomalies are present in nearly half of > 2500 g birth weight infants diagnosed with necrotizing enterocolitis. Morbidity and mortality increase with sepsis, surgical disease, and congenital anomalies.Type of study
Prognosis Study.Level of evidence
Level II. 相似文献73.
74.
Simon Modi Robert Cooper Mark Hall Jay Wright Derick Todd 《Emergency medicine Australasia : EMA》2010,22(4):347-350
Chest pain in pacemaker patients can be difficult to evaluate due to alterations in QRS and ST segments on the surface ECG. A high prevalence of ischaemic heart disease in this population also serves to influence the differential diagnosis. We highlight four cases, all with simple yet informative imagery, in an attempt to alert clinicians of worrying signs. 相似文献
75.
Jeffrey W-D Foy Kay Rittenhouse Marlene Modi Manju Patel 《Journal of ocular pharmacology and therapeutics》2007,23(5):452-466
PURPOSE: To evaluate the local tolerance, systemic toxicity, and toxicokinetics in dogs and rabbits of pegaptanib sodium, an aptamer that targets vascular endothelial growth factor (VEGF(165)). METHODS: Dogs received biweekly, bilateral, intravitreous (IVT) injections of pegaptanib sodium for 9 months at doses of 0.3 (n = 10), 1 (n = 10), or 3 mg (n = 14); 14 control dogs received phosphate-buffered saline (PBS). In rabbits, pegaptanib sodium was administered by IVT injection biweekly for 6 months at doses of 0.2 (n = 14), 0.67 (n = 14), or 2 mg (n = 18); 18 rabbits received PBS. The systemic and ocular safety of pegaptanib sodium was assessed. Assessments in both dogs and rabbits included complete ophthalmologic examinations, serum chemistry, hematology, urinalysis, and coagulation assessments, as well as gross and microscopic pathologic examination. In addition, dogs were assessed by electroretinography and electrocardiography. In a cardiovascular safety study, loading intravenous boluses and maintenance infusions of pegaptanib sodium or PBS were administered to dogs (n = 4) in an ascending dose design, with each dose level separated by 2-3 days. The pegaptanib dosing regimens were designed to achieve pegaptanib plasma concentrations of approximately 90, 270, or 900 ng/mL. RESULTS: There were no pegaptanib sodium-associated clinical, ophthalmologic, pathologic, or cardiovascular abnormalities at doses of pegaptanib that achieved systemic and ocular exposure levels in excess of those associated with the recommended pegaptanib IVT dosing regimen of 0.3 mg per study eye in patients with age-related macular degeneration. CONCLUSION: These studies, together with data from clinical trials, provide strong evidence that inhibition of VEGF(165) by pegaptanib in the eye is a safe therapy for the treatment of ocular neovascular disease. 相似文献
76.
77.
M. C. Shah M.D. U. J. Modi M.D. R. V. Bhatt M.D. K. P. Mistry Ph.D. 《Indian journal of pediatrics》1983,50(3):271-274
The amniotic fluid composition of 74 pregnant women having abnormalities was compared with those of 70 normal pregnant women.
Women having small for gestational age children showed a decrease of creatinine level and an increase of locithin to sphingomyelin
(L/S) ratio. Anomic mothers had higher alkaline phosphatase. The calcium and creatinine were decreased and protein was increased
in amniotic fluid of premature deliveries. 相似文献
78.
79.
Imura H Modi P Pawade A Parry AJ Suleiman MS Angelini GD Caputo M 《The Annals of thoracic surgery》2002,74(6):22-2002
BACKGROUND: Cardiac troponin I (TnI) is a sensitive and specific marker of myocardial injury, but little is known about its release after complex congenital heart surgery. We investigated whether TnI correlates with early clinical outcome in neonates undergoing the arterial switch operation (ASO) for transposition of the great arteries (TGA). METHODS: Troponin I was measured serially up to 48 hours postoperatively in 31 neonates undergoing the ASO alone (simple TGA) and 9 neonates undergoing the ASO combined with other procedures (complex TGA) (eg, closure of a ventricular septal defect) and correlated with intraoperative and postoperative clinical parameters. RESULTS: There was no mortality. Troponin I peaked at either 4 or 12 hours postoperatively in all patients (median for simple TGA = 3.4 ng/mL, interquartile range 2.4 to 4.6; median for complex TGA = 4.7 ng/mL, interquartile range 3.2 to 6.8, p = 0.20). Peak TnI correlated with the durations of inotropic support (r = 0.54, p < 0.001), ventilation (r = 0.51, p < 0.01), and intensive care unit stay (r = 0.50, p < 0.01). The duration of cardiopulmonary bypass, aortic cross-clamping, and circulatory arrest did not correlate with the peak or total TnI release. The duration of aortic cross-clamping correlated poorly with the duration of inotropic support (r = 0.40, p < 0.05). The complex TGA group had longer aortic cross-clamp times, required more postoperative inotropic support, and had significantly higher total TnI release compared with the simple TGA group. CONCLUSIONS: There are weak but statistically significant correlations between peak TnI and clinical outcome. Complexity of the defect and ischemic times may be as useful to predict outcome in this group of patients. 相似文献
80.
Ascione R Modi P Triggiani D Iannelli G Spampinato N 《The Journal of cardiovascular surgery》2002,43(2):251-254
We report the development of two anastomotic pseudoaneurysms in a patient with Beh?et's disease eighteen months after abdominal aortic aneurysm repair. Major asymptomatic vascular complications should be suspected in patients with Beh?et's disease with a history of vascular surgery and treated expediently due to the risk of rupture. Magnetic resonance angiography, contrast-enhanced computed tomography or ultrasound scanning should be performed at least every 6 months after vascular surgery. 相似文献